Abstract
Introduction
BMs are rare in NENs; optimal management warrants global consensus.
Aim
To review the current management and outcomes of pts with BMs in NENs.
Methods
This retrospective study included consecutive pts with a NEN (excluding G3 lung) treated at an ENETS Centre of Excellence (April’02-March’18). Pts demographics, nature of BMs, treatment and overall survival (OS) were evaluated (SPSS v23.0/STATA v12).
Results
Of 1459 pts screened, 85 (7%) had BMs. Primary tumour: gastro-entero-pancreatic 49%, lung 25%, unknown primary 20%, and “others” 6%; grade 1-2 67%; 41% functional. BMs were ‘widespread’ in 61% of pts and synchronously diagnosed with other metastatic sites in 55%. In 45% of pts, BMs were ‘late events’ (non-synchronous), with median time-to-BMs of 14.0 months(m) (95%CI 3.1-24.9). BMs were symptomatic in 78% of pts: frequency and time-to-event (if asymptomatic at diagnosis of BM) for pain was 61% and 2.2m (95%CI 1.8-6.6), hypercalcaemia: 4% and 14.6m (95%CI 12.9-72.0) and skeletal-related events: 20% (including fracture [11% and 7.7m (95%CI 0.3-14.9)] and cord compression [11% and 14.2m (95%CI 0.3-118.9)]), respectively. Management of BMs included: analgesia 44%, radiotherapy 34%, bisphosphonates 22% and surgery 2%. Median OS from identification of BMs was 31.0 months (95%-CI 19.6-42.4) and 18.9 months (95%-CI 8.7-29.1) from time of development of BM-related symptoms. On multivariable Cox Regression, age (p 0.008) and performance status (p 0.001) were independent factors associated with shorter OS.
Conclusions
Most pts with BMs will become symptomatic with variable time-to-symptom development. Optimal guidance on management of BMs to improve pts outcomes and quality of life is necessary.
BMs are rare in NENs; optimal management warrants global consensus.
Aim
To review the current management and outcomes of pts with BMs in NENs.
Methods
This retrospective study included consecutive pts with a NEN (excluding G3 lung) treated at an ENETS Centre of Excellence (April’02-March’18). Pts demographics, nature of BMs, treatment and overall survival (OS) were evaluated (SPSS v23.0/STATA v12).
Results
Of 1459 pts screened, 85 (7%) had BMs. Primary tumour: gastro-entero-pancreatic 49%, lung 25%, unknown primary 20%, and “others” 6%; grade 1-2 67%; 41% functional. BMs were ‘widespread’ in 61% of pts and synchronously diagnosed with other metastatic sites in 55%. In 45% of pts, BMs were ‘late events’ (non-synchronous), with median time-to-BMs of 14.0 months(m) (95%CI 3.1-24.9). BMs were symptomatic in 78% of pts: frequency and time-to-event (if asymptomatic at diagnosis of BM) for pain was 61% and 2.2m (95%CI 1.8-6.6), hypercalcaemia: 4% and 14.6m (95%CI 12.9-72.0) and skeletal-related events: 20% (including fracture [11% and 7.7m (95%CI 0.3-14.9)] and cord compression [11% and 14.2m (95%CI 0.3-118.9)]), respectively. Management of BMs included: analgesia 44%, radiotherapy 34%, bisphosphonates 22% and surgery 2%. Median OS from identification of BMs was 31.0 months (95%-CI 19.6-42.4) and 18.9 months (95%-CI 8.7-29.1) from time of development of BM-related symptoms. On multivariable Cox Regression, age (p 0.008) and performance status (p 0.001) were independent factors associated with shorter OS.
Conclusions
Most pts with BMs will become symptomatic with variable time-to-symptom development. Optimal guidance on management of BMs to improve pts outcomes and quality of life is necessary.
| Original language | English |
|---|---|
| Pages | 1-273 |
| Publication status | Published - 6 Mar 2019 |
| Event | 16th Annual ENETs conference - Barcelona, Barcelona, Spain Duration: 6 Mar 2019 → 8 Mar 2019 |
Conference
| Conference | 16th Annual ENETs conference |
|---|---|
| Country/Territory | Spain |
| City | Barcelona |
| Period | 6/03/19 → 8/03/19 |
Keywords
- Neuroendocrine tumours
- Bone metastases
Research Beacons, Institutes and Platforms
- Manchester Cancer Research Centre
